■ PHYSICAL  ECONOMICS. 


[Comprising  a mathematical  formula  for  the  normal 
earning  ability  of  the  body  by  which,  with  the  requisite 
data  a person  may  be  either  rated,  or  his  economic  value 
may  be  ascertained,  and  thereby  damages  to  his  body  from 
injury  or  disease,  with  an  indemnity  to  be  allowed  therefor, 
may  be  determined  in  a manner  equitable  to  all  concerned.] 


ERASTUS  EUGENE  HOLT,  A.M.,  M.D.,  LL.D. 


PORTLAND,  MAINE. 


M L ^ ' 

< . . T'  . ' fc  > I I -—7—  ■ 


JlTlVI  1,  " I 1 ' 1 1 t I » 

- (.i  j.  j. / I,  ;■  ^ ’ 


Reprinted  from  The  Journal  of  the  American  Medical  Association, 
July  21, 1906,  Vol.  xlvii,  pp.  19i-204. 


CHICAGO : 

PUESS  OP  THE  AMERICAN  MEDICAL  ASSOCIATION, 
ONE  HUNDRED  AND  THREE  DEARBORN  AVENUE, 

1906. 


(^omrnrrco.  2vl0C>*t  Ta\|Io'*'  ,?.S 


■RA 


y 

— i. 


)o64 
° H ip^f\ 


a PHYSICAL  ECONOMICS.* 

Vy 

[Comprising  a mathematical  formula  for  the  normal 
^ earning  ability  of  the  body  by  which,  with  the  requisite 

data  a person  may  be  either  rated,  or  his  economic  value 
may  be  ascertained,  and  thereby  damages  to  his  body  from 
injury  or  disease,  with  an  indemnity  to  be  allowed  therefor, 
may  be  determined  in  a manner  equitable  to  ail  concerned.  J 


ERASTUS  EUGENE  HOLT,  A.M.,  M.D.,  LL.D. 

PORTLAND,  MAINE. 


An  oculist,  when  called  on  to  ascertain  damages  to 
the.  eyes  from  an  injury,  frequently  meets  with  other 
disabilities  of  the  body  which  occurred  at  the  same  time. 
If  he  works  in  connection  with  other  physicians  and 
surgeons  who  are  to  determine  damages  to  other  parts 
of  the  body,  it  is  highly  important  that  there  should  be 
standard  methods  of  procedure  which  can  be  applied  to 
every  system  and  organ  of  the  body  so  that  each  may 
understand  the  other  and  work  together  to  obtain  results 
on  a scientific  basis.  The  object  of  this  paper  is  to  pro- 
mulgate methods  by  which  this  may  be  accomplished  in 
a manner  equitable  to  all  concerned. 

The  problem  is  a mixed  one,  inasmuch  as  w^e  must 
have  a method  for  ascertaining  the  economic  value  of  a 
person  both  before  and  after  he  has  been  damaged  from 
injury  or  disease.  All  recognize  the  importance  of 
scientific  methods  for 'solving  this  problem,  but  no  one 
has  had  the  temerity  to  attempt  to  overcome  the  diffi- 
culties surrounding  it.  It  occurred  to  me,  liowever, 
while  I was  disabled  from  an  injury,  received  in  1903, 
that  if,  when  the  eyes  were  damaged,  the  remaining 
earning  ability  could  be  determined  by  a mathematical 
formula,  based  on  the  principles  employed  in  the  natural! 
sciences  in  measuring  any  power,  as  had  been  done  bv 
Magnus^  of  Germany,  the  principle  might  be  utilized' 

♦ Read  in  the  Section  on  Ophthalmology  of  the  American' 
Medical  Association,  at  the  Fifty-seventh  Annual  Session,  June,  1906. 

1.  “Visual  Economics,”  by  Dr.  PI.  Magnus  of  Breslau,  Germany, 
translated  with  additions  by  Dr.  H.  V.  Wiirdemann,  Milwaukee,. 

Wis. 


p A.  (b  ^ 


2 


for  the  whole  body.  I,  therefore,  spent  many  of  the 
long  weary  hours  of  my  disability  in  thinking  how  this 
could  be  accomplished.  After  I had  adapted  the  princi- 
ple to  the  whole  body,  it  seemed  so  simple  that  I won- 
dered if  some  one  had  not  solved  the  problem  in  a simi- 
lar way.  On  making  inquiries  in  connection  with  the 
reprints  of  my  papers  among  many  persons  I have 
failed  to  find  any  one  who  had  solved  the  problem  in 
this  manner. 

Professor  Seaver,  formerly  director  of  the  gymnasium 
of  Yale  University,  replied: 

I wish  to  thank  you  for  a reprint  on  “Physical  Economics” 

. . . which  strikes  me  as  a very  valuable  contribution  on 

a subject  to  which  I have  given  considerable  thought  without 
being  able  to  arrive  at  definite  conclusions,  and  so  I have 
never  published  anything.  You  have  hit  on  a practical  method 
of  rating  a man’s  physical  utility  so  far  as  the  physical  side 
of  him  is  concerned,  as  mental  rating  is  given  by  intellectual 
tests,  so  that  we  may  have  a fairly  accurate  mathematical 
statement  of  his  probable  worth  to  society. 

Professor  Bowditch,  of  the  Harvard  Medical  School, 
with  several  others,  referred  me  to  ^‘^Vital  Statistics:  a 
Memorial  Volume  of  Selections  from  the  Eeports  and 
Writings  of  William  Farr,  M.D.,  D.C.L.,  C.B.,  F.K.S., 
edited  by  Noel  A.  Humphreys.^^  Dr.  Farr  spent  his  life 
in  the  Eegistrar-GeneraPs  office  of  England,  where  by 
his  writings  on  vital  statistics  and  allied  subjects  he 
rendered  one  of  the  greatest  services  to  his  country  that 
ever  fell  to  the  lot  of  man,  and  which  made  him  an 
authority  on  these  subjects  throughout  the  whole  civil- 
ized world. 

In  this  work,  under  the  head  of  ^^Cost  and  the  Pres- 
ent and  Future  Economic  Value  of  Man,”  we  find: 
“The  characteristics  of  life  property  in  wages  and  in 
income  from  professions,  commerce,  trades  and  manu- 
factures is  that  it  is  inherent  in  man  and  is  the  value  of 
his  services — of  the  direct  product  of  his  skill  and  indus- 
try. In  slaves  it  is  vendible  and  transferable;  in  free- 
men it  is  inalienable ; but  is  not  the  less  on  that  account 
property  which  in  the  early  states  of  society  is  assessed 
and  taxed  in  the  form  of  personal  services.  It  is  com- 
bined with  stock  in  all  production;  and  the  proportion 
of  the  elements  varies  in  every  kind  of  product.  The 
labor  of  the  parents  and  the  expenses  of  attendance, 
nurture,  clothing,  lodging,  education,  apprenticeship, 
practice,  are  investments  of  capital,  at  risk  extending 


3 


over  many  years ; and  the  return  appears  in  the  form  of 
the  wages,  salaries  or  income,  of  the  survivors,  com- 
mencing at  various  ages,  12,  15,  21,  24,  30,  33,  36,  39, 
and  ages  still  greater;  for  the  incomes  in  the  higher 
professions  increase  probably  up  to  the  age  of  50  or 
55.  The  outgo  increases  from  infancy  up  to  a certain 
age;  the  earnings  then  commence,  and  ere  long  equal 
the  outgo;  they  are  subsequently  in  excess  throughout 
manhood,  and  at  advanced  age  decrease,  until  they  are 
extinguished  amidst  the  feebleness  and  infirmities  of  old 
age.  The  present  value  of  the  personas  probable  future 
earnings,  minus  the  necessary  outgo  in  realizing  these 
earnings,  is  the  present  value  of  that  personas  services. 
Like  capital  invested  in  the  soil,  in  the  vintage,  or  in  a 
commercial  adventure,  the  capital  invested  in  the  life 
of  man  returns,  in  happy  natures,  profit  of  a hundred- 
fold; in  other  cases  fifty,  twenty,  tenfold;  in  others  it 
is  barely  returned;  in  some  it  is  entirely  lost,  either  by 
death,  sickness,  vice,  idleness,  or  misfortune.'’^ 

On  the  ^^Economic  Effect  of  Death  by  Different  Dis- 
eases,” he  says:  ^^Life  has  a pecuniary  value.  In  its 
production  and  education  a certain  amount  of  capital 
is  sunk  for  a longer  or  shorter  time,  and  that  capital, 
with  its  interest,  as  a general  rule,  reappears  in  wages 
of  the  laborer,  the  pay  of  the  officer,  and  the  income  of 
the  professional  man.  At  first  it  is  all  expenditure, 
and  a certain  necessary  expenditure  goes  on  to  the  end 
to  keep  life  in  being  even  when  its  economic  results  are 
' negative. 

^^The  value  of  any  class  of  lives  is  determined  by 
valuing  first  at  birth,  or  at  any  age,  the  cost  of  future 
maintenance,  and  then  the  value  of  the  future  earnings. 
Thus  proceeding,  I found  the  value  of  a Norfolk  agri- 
cultural laborer  to  be  £246  at  the  age  of  25;  the  child 
is  by  this  method  worth  only  £5  at  birth,  £56  at  the  age 
of  5 ; £117  at  the  age  of  10;  the  youth  £192  at  the  age 
of  15 ; the  young  man  £234  at  the  age  of  20 ; the  man 
£246  at  the  age  of  25,  and  £241  at  the  age  of  30,  when 
the  value  goes  on  declining  to  £138  at  the  age  of  55, 
and  only  £1  at  the  age  of  70;  the  cost  of  maintenance 
afterward  exceeding  the  earnings,  the  value  becomes 
negative;  at  80  the  value  of  the  cost  of  maintenance 
exceeds  the  value  of  the  earnings  by  £41.  These  values 
.may  be  compared  with  the  former  cost  of  slaves  in 
Eome,  in  the  United  States,  and  in  the  West  Indies. 


4 


‘‘The  amount  of  capital  sunk  in  the  education  of  pro- 
fessional men  is  not  only  greater,  but  it  is  probably  at 
greater  risk,  and  it  has  to  remain  longer  under  in\e8t- 
ment  before  it  is  returned.  The  maximum  value  of 
such  a man  is  attained  later  in  life,  probably  40;  and 
in  the  highest  orders  of  the  church,  law,  and  politics, 
where  experience  and  great  weight  of  character  are 
requisite,  the  life  still  increases  in  value  at  higher  ages.” 

This  method  employed  by  Dr.  Farr,  and  other  high 
authorities,  for  ascertaining  the  present  value  of  a per- 
son, at  any  age,  must  be  accepted  as  the  correct  one  for 
determining  the  economic  value  of  a human  being.  It 
necessarily  involves  a knowledge  of  the  bodily  functions, 
for  on  the  physical  condition  of  a person  depends  his 
prospective  earning  ability;  therefore,  an  examination 
of  the  body  must  be  made  to  decide  whether  it  is  in  a 
condition  to  meet  the  exppctations  of  a working  life  at 
that  age.  If  the  examination  revealed  conditions  which 
are  known  to  lessen  tin-  ‘Expectation  of  life,  then  this 
fact  must  be  taken  into  consideration  in  the  calculation 
and  materially  modifies  the  results. 

The  present  value  of  the  net  yearly  earnings  (‘f  a 
person  for  a prospective  working  life  is  the  sum  of  tli^Ese 
net  earnings  when  discounted  at  the  rate  of  interest, 
used  in  the  computation,  compounded  for  each  of  the 
series  of  years  before  they  will  be  realized.  This  makes 
the  interest  account  of  very  great  economic  importance 
in  the  problem,  because  the  present  value  of  any  sum, 
due  any  number  of  years  hence,  depends  on  the  rate  of 
interest  per  annum  and  the  number  of  years  before  it 
becomes  due.  The  present  value  is  very  much  less  when 
a high  rate  of  interest  is  used  than  when  a low  rate  of 
interest  is  used  in  the  computation,  for  it  is  the  reverse 
of  a sum  to  be  realized  at  compound  interest  in  the 
future. 

In  the  computation  carried  out  in  the  work  of  Magnus 
already  referred  to,  the  gross  earnings  are  taken  and 
multiplied  by  the  years  of  the  prospective  working  life 
as  a base  on  which  to  determine  the  damages.  It  is 
manifestly  wrong  to  take  the  gross  earnings  of  a person 
for  a base  on  which  to  determine  damages  to  his  body, 
for  if  a man  was  totally  disabled  he  should,  according 
to  this  method,  receive  an  indemnity  equal  to  his  gross 
earnings.  We  must  keep  constantly  in  view  that  the 
solution  of  this  problem  is  based  entirely  on  the  present 


5 


economic  value  of  a person,  and  that  this  economic 
value  must  be  determined  from  his  age  and  his  net 
annual  earning  ability  for  a prospective  working  life  at 
a rate  of  interest  to  be  realized  on  a long  time,  as  we 
have  shown  by  a quotation  from  the  writings  of  Dr. 
Farr,  whose  authority  is  recognized  throughout  the  civ- 
ilized world.  There  might  be  fixed  a value  for  a person 
whose  earnings  only  equalled  or  were  less  than  his  ex- 
penses in  realizing  those  earnings,  but  it  would  have  to 
be  estimated  on  a philanthropic  and  not  on  an  economic 
basis. 

The  method  employed  by  Dr.  Farr  for  determining 
the  present  value  of  a person  from  the  net  yearly  income 
of  his  normal  earning  ability  has  much  in  common  with 
the  principle  employed  in  life  insurance,  and,  therefore, 
is  just  as  accurate  and  reliable  in  its  results,  especially 
when  obtained  with  the  same  care  as  to  all  the  details. 
The  economic  value  of  a person  at  the  time  of  the  acci- 
dent is  the  base  on  which  to  compute  his  economic  loss. 
After  we  have  ascertained  his  remaining  earning  ability 
in  the  form  of  a fraction  of  the  normal,  the  economic 
loss  may  be  obtained  in  dollars  and  cents. 

For  the  purpose  of  determining  the  remaining  earn- 
ing ability  of  a person  damaged  from  injury  or  disease, 
we  need  a mathematical  formula  for  the  normal  earning 
ability  of  the  body. 

In  the  analysis  of  a person  to  determine  the  elements 
which  are  indispensable  for  his  normal  earning  ability 
and  which  m_ay  be  used  as  factors  to  express  them  in  a 
mathematical  formula,  we  find  that  the  functions  of  the 
body  in  a fairly  normal  condition  are  of  first  impor- 
tance. This  constitutes  the  functional  ability  of  the 
person  and  the  factor  of  first  importance  in  the  formula. 

A person  would  be  of  very  little  use,  economically,  in 
the  world  without  having  had  that  training  of  the  mind 
and  body  which  would  fit  him  to  follow  some  occupation 
successfully.  This  constitutes  the  technical  ability  of  a 
person  and  the  second  factor  in  the' formula.  With  the 
functional  and  technical  ability  of  the  first  order,  there 
is  another  element  of  a person  of  considerable  impor- 
tance, namely,  his  ability  to  secure  and  perform  the 
duties  of  an  occupation  successfully.  It  makes  no  dif- 
ference whether  his  services  are  rendered  direct  to  the 
general  public  or  through  some  employer;  his  success 
depends  on  his  ability  to  obtain  work  and  to  serve  those 


6 


who  employ  him.  This  constitutes  the  competing  abil- 
ity of  a person  and  the  last  factor  in  the  formula. 
Therefore,  the  three  elements  of  a person  which  are 
absolutely  indispensable  to  his  normal  earning  ability 
are,  first,  the  functional  ability;  second,  the  technical 
ability,  and,  third,  the  competing  ability.  This  analysis 
of  a person  includes  everything  needed  in  the  perform- 
ance of  the  duties  of  any  occupation.  It  may,  therefore, 
be  considered  complete,  and,  moreover,  it  is  in  accord- 
ance with  the  principles  employed  in  the  analysis  of  any 
physical  force  by  which  its  efficiency  is  determined.  The 
acceptance  of  this  analysis  of  a person  is  of  prime  im- 
portance to  an  understanding  of  the  mathematical 
formula  for  the  normal  earning  ability  of  the  body,  be- 
cause its  object  is  to  determine  the  essential  elements 
which  may  be  used  as  factors  in  the  formula. 

In  a similar  way  that  much-used  substance  called 
electricity  has  been  analyzed;  the  unit  of  the  electro- 
motive force  being  designated  as  a volt,  which  is  a cur- 
rent of  one  ampere,  with  a‘  resistance  of  one  ohm.  The 
amount  of  electricity  is  obtained  by  multiplying  these 
three  elements  together,  producing  a composite  quantity 
called  watts,  746  of  which  make  a horse-power.  By 
using  the  first  letter  of  each  word  this  process  is  repre- 
sented in  the  formula  W ==  V A 0.  When,  however, 
electricity  is  obtained  by  this  standard  of  resistance,  its 
efficiency  is  determined  by  multiplying  volts  by  amperes, 
and  the  formula  thus  simplified  is  W = V A. 

In  a similar  manner  if  we  use  the  first  letter  of  the 
prominent  word  in  the  analysis  of  a person,  F = the 
functional ; T = the  technical ; C = the  competing,  and 
E = the  earning  ability  of  a person;  hence  E = 
FTC,  the  mathematical  formula  for  the  normal  earn- 
ing ability  of  the  body: 

These  three  factors  are  not  of  equal  value,  although 
the  efficiency  of  each  is  interdependent  on  the  other,  F 
being  first  in  importance;  T second  in  importance; 
whereas  C is  least  important,  because  it  depends  on  the 
other  two  and  the  conditions  of  the  labor  market.  The 
competing  ability  is  composed  of  the  same  elements  as 
F and  is  modified  to  a similar  but  less  extent  when  F is 
impaired.  It  is  also  modified  by  T and  the  way  em- 
ployers and  the  public  consider  the  person,  especially 
when  he  has  been  damaged  by  injury  or  disease.  There- 
fore, to  meet  all  these  conditions,  C must  be  placed 


7 


under  a radical  in  the  formula,  the  index  of  which  may 
be  designated  by  an  X to  indicate  that  it  is  to  be  de- 
termined in  each  instance,  and  the  formula  thus  modi- 
fied is  E = F T v/'(X 

To  amplify  the  formula,^  F must  be  resolved  into  its 
component  parts  by  selecting  and  grouping  into  the 
form  of  units  such  systems  and  organs  as  are  so  inter- 
dependent that  each  is  needed  to  insure  the  functions 
of  the  other  in  its  particular  unit,  and  these  systems  and 
organs  taken  together  form  a unit  that  is  absolutely 
indispensable  to  the  functions  of  the  body.  These 
units  are  to  be  regarded  as  factors  of  F,  which  when 
multiplied  together,  and  by  the  other  two  factors  of  the 
formula,  produce  the  composite  quantity  E.  As  much 
as  possible,  systems  and  organs  have  been  selected  and 
grouped  together  as  units  in  accordance  with  their  de- 
velopment and  associated  functions,  it  being  found  nec- 
essary to  have  four  such  units  for  the  whole  body,  which 
when  designated  by  the  first  four  letters  of  the  alphabet 
are  as  follows : 


, the  bones, 

, the  joints, 

, the  muscles. 

, the  heart, 

, the  vessels, 

, the  lungs  and  their  accessory 
organs. 

:,  the  alimentary  canal, 

, its  accessory  organs, 

1,  the  kidneys  with  the  genital 
^ organs. 

f n,  the  brain,  its  membranes,  and  its' 
r Cerebro-spi-  1 nerves, 

I nal  systems,  | o,  the  spinal  cord,  its  membranes,  its 
d =-{  nerves  and  -{  anterior  motor,  and  its  poster- 

I ganglia,  con-  I ior  sensory  nerves, 

' Insisting  of  p,  nerves  and  organs  of  special 
1.  sense. 

Each  of  these  units  fulfills  the  requirements  of  our 
definition:  it  is  composed  of  systems  and  organs  so  in- 
terdependent that  each  is  needed  to  insure  the  functions 
of  the  other,  and  these  taken  together  form  a unit  that 
is  absolutely  indispensable  to  the  functions  of  the  body. 
This  being  true,  the  value  of  the  function  of  each  unit 
may  be  obtained  by  a formula  similar  to  that  employed 
in  determining  the  value  of  any  physical  force.  In 
amplifying  F,  by  resolving  it  into  its  component  parts, 
as  factors,  a,  b,  c,  d,  each  of  these  was  resolved  into  its 


I the  sympa- 
f-tlietic  nerves 
I and  ganglia. 


b = 


5 Osseous,  articular,  and 
1 muscular  systems,  consisting  of 

5 Circulatory  and  respiratory 
1 systems,  consisting  of 


5 Digestive  and  genito-urinary 
( systems,  consisting  of 


2.  The  remainder  of  this  discussion  of  the  formula  is  from  my 
article  in  the  second  and  enlarged  edition  of  the  Encyclopedia 
Americana. 


8 


component  parts,  as  factors,  and  a = efg;b  = hij: 
c = k 1 m ; and  d=  nop. 

In  any  computation,  if  one  of  the  factors  becomes  0, 
the  product  is  0.  In  diseases  of  the  bones,  like  osteo- 
malacia, producing  an  inability  to  support  the  body,  e 
would  become  0,  then  a = 0 ; in  inflammation  of  the 
joints,  like  chronic  articular  rheumatism,  causing  a 
large  number  of  stiff  joints,  f would  become  0,  and 
a = 0;  in  diseases  and  injuries  producing  paralysis  of 
the  muscles,  g would  become  0,  then  a = 0,  and  finally, 
in  diseases  and  injuries  by  which  a large  portion  of  the 
extremities  were  lost,  a certainty  would  become  0,  and 
if  a = 0 then  F = 0.  In  serious  valvular  and  organic 
diseases  of  the  heart,  or  vessels,  h or  i would  become  0, 
then  b = 0 ; in  serious  diseases  of  the  lungs  and  their 
accessory  organs,  j would  become  0,  then  b = 0,  and  if 
b = 0,  then  F = 0.  Iff  the  various  serious  diseases  of 
the  alimentary  canal,  its  accessory  organs,  the  kidneys 
with  the  genital  organs,  each  of  k,  1,  m,  might  become 
0,  then  c = 0,  and  F = 0 ; and  in  the  various  serious 
diseases  of  the  brain,  spinal  cord,  and  organs  of  special 
sense,  each  of  n,  o,  p,  might  become  0,  then  d = 0,  and 
F = 0,  and  finally,  if  F — 0,  then  E = 0.  Therefore, 
the  parts  of  each  unit,  as  factors,  bear  the  same  relation 
to  the  unit,  as  the  units,  as  factors,  do  to  the  whole  body. 
Each  part,  as  factor,  is  indispensable  to  the  other,  and 
each  unit  as  factor  is  indispensable  to  the  body.  The 
units  are  always  to  be  regarded  as  factors  of  F,  and 
multiplied  together  and  by  the  other  two  factors  of  the 
formula,  if  we  are  to  conceive  of  the  earning  ability  of 
the  body  as  a whole  which  can  be  given  a mathematical 
expression.  Our  formula  represents,  mathematically, 
the  complete  earning  ability  of  the  body  in  a healthy 
normal  person,  which  is  a composite  quantity,  resulting 

As  has  already  been  shown,  when  F is  resolved  into 
from  the  multiplication  of  factors;  the  same  as  was 
\ done  in  obtaining  the  efficiency  of  electricity. 
its  component  parts,  as  factors,  it  is  represented  by 

X X 

(abed)  andv'c,  becomes  ^/{a  b c d),  because  C is 
composed  of  the  same  elements  as  F;  hence  the  com- 
plete formula  for  the  normal  earning  ability  is  E = 

X 

(abed)  T >/(a  b c d).  Now  in  this  formula  the 
units,  or  factors,  are  not  of  equal  value,  and,  hence, 
when  damage  to  them  has  been  ascertained  by  scientific 


standards  of  measurement  they  may  be  placed  in  the 
formula  under  a radical,  the  index  of  which  will  de- 
pend on  how  much  less  it  is  desired  the  damaged  units 
shall  affect  the  formula  than  that  given  to  them  by 
scientific  standards  of  measurement.  The  unit,  d,  rep- 
resenting the  cerebrospinal  systems,  nerves,  and  ganglia, 
would  under  almost  all  circumstances  be  placed  in  the 
formula  at  its  full  value,  as  determined  by  scientific 
standards  of  measurement,  as  any  damage  to  it  pro- 
duces in  the  person  thus  affected  proportional  disability 
for  all  gainful  occupations. 

To  ascertain  the  remaining  value  of  a unit  in  a given 
case  of  damage,  it  must  be  compared  with  some  scien- 
tific standard  of  measurement,  and  the  remaining  value 
given  in  the  form  of  a fraction  of  the  whole  unit.  This 
method,  which  permits  of  the  mathematical  determina- 
tion of  each  unit  of  the  bodily  function,  as  a fraction  of 
the  normal  unit  must  be  considered  complete,  as  it  is 
in  accordance  with  the  principles  laid  down  by  the 
natural  sciences  in  measuring  the  power  of  any  ph5^sical 
force,  one  of  which,  that  of  electricity,  has  been  given. 

“The  four  units  of  F,  or  their  remaining  value,  after 
being  damaged,  must  always  be  regarded  as  factors  and 
multiplied.  Their  product  is  a composite  quantity — the 
earning  ability  of  the  body.  They  must  never  be  regarded 
as  quantities  to  be  added,  for  wrong  practical  deductions 
would  be  obtained^  as  the  following  will  clearly  show : 

X ^ 

In  the  formula,  E = (a  b c d)  T ^ (a  b c d),  let  us 
suppose  that  from  an  injury  a person  was  rendered 
blind  and  deaf,  and  that,  therefore,  the  unit,  d,  becomes 
0.  It  is  self-evident  that  a person  in  this  condition 
would  have  no  earning  ability,  and  yet,  if  we  add  the 
remaining  units,  a,  b,  and  c,  which  might  be  normal, 
we  would  obtain  three-fourths  of  the  earning  abil- 
ity of  the  body,  which  results  in  a reductio  ad  absur- 
dum.  With  a,  b,  c,  d,  of  oUr  formula  regarded  as  fac- 
tors, to  be  multiplied,  however,  when  d,  or  any  other 
factor,  becomes  0,  the  product  is  0,  also,  and  no  ab- 
surdity results,  because  in  any  computation,  if  one  of 
the  factors  is  0,  the  product  will  always  be  0.  If  a 
person  has  no  technical  ability,  T would  be  0,  and, 
therefore,  E = 0.  This  would  be  true  in  actual  prac- 
tice. Finally,  if  we  decide  that  a person  has  no  com- 
peting ability  x = 0,  and  E = 0,  and  this  would  be 
true  in  the  labor  markets,  notwithstanding  the  bodily 


10 


functions  might  be  normal  and  the  technical  ability 
might  be  of  the  highest  order,  yet  if  the  personas  serv- 
ices were  not  needed  and  he  could  not  dispose  of  them 
at  any  price,  his  earning  ability  would  be  0.  There- 
fore, in  our  mathematical  formula  for  the  normal  earn- 
ing ability  of  the  body,  if  any  one  of  the  units  as  fac- 
tors becomes  0,  then  E = 0,  and  no  absurdity  results. 
We  have,  at  some  length,  dwelt  on  F,  of  our  formula, 
because  it  is  the  most  important  factor  in  it.  We  now 
pass  on  to  T,  the  next  in  importance. 

The  technical  ability  of  a person  is  usually  gained 
during  adolescence,  and  is  generally  attained  by  the 
time  the  growth  of  the  body  is  completed.  The  formula 
may  be  used  as  a guide  during  the  years  of  growth  and 
development  and  serve  to  rate  the  youth,  taking  into 
•consideration  the  condition  of  the  functional  ability  on 
which  the  mental  and  technical  ability  so  much  depend, 
but  which  has  been  heretofore  practically  ignored.  As 
important  as  T is  to  the  normal  earning  ability,  and  in 
rating  a person,  when  that  person’s  vocation  becomes 
fixed,  T may  be  considered  as  equal  to  one  in  estimating 
damages.  The  technical  ability  is  not  injured,  but  lim- 
ited only  in  proportion  to  the  damages  to  F,  impair- 
ment of  which  will  include  these  damages;  therefore,  T 
may  be  omitted,  and  the  formula  thus  modified  for  de- 
termining damages  to  the  earning  ability  of  the  body  is 

E ==  (a  b c d)  -s/(a  b c d) 

We  now  come  to  C,  the  third  and  last  factor  of  our 
formula.  The  ability  to  compete  is  a condition  which  is 
affected  by  a variety  of  circumstances;  first,  by  the  per- 
son’s functional  ability ; second,  by  his  technical  ability ; 
and,  third,  by  the  way  employers  consider  these  condi- 
tions, together  with  the  supply  and  demand  for  labor. 
Therefore,  when  a person  becomes  disabled,  the  damage 
to  his  body  acts  immediately  in  two  ways : first,  by  its 
direct  impairment  of  the  functional  ability,  according 
to  the  nature  and  extent  of  the  damage  by  reason  of 
which  he  will  not  be  able  to  perform  so  much,  and  per- 
haps not  so  good  work,  as  he  did  before;  and,  second, 
by  the  way  employers  consider  these  conditions.  The 
damage  to  the  body  might  be  of  such  a nature  as  to  ef- 
fect the  appearance  of  the  person  without  interfering 
materially  with  his  earning  ability;  such  as  in  the  unit 
a,  loss  of  the  auricles,  or  nose ; in  the  unit  d,  a large 
scar  of  the  cornea,  or  an  injury  to  a blind  eye  causing  it 


11 


to  become  crossed.  Disfigurements  like  these,  although 
not  interfering  with  a personas  ability  to  work  as  well  as 
he  did  before  the  damage  was  done,  would  seriously  in- 
terfere with  his  chances  to  obtain  employment,  and 
should,  therefore,  be  considered  a serious  obstacle  to  his 
competing  ability.  In  case  of  damages,  a person  has  a 
right  to  secure  compensation,  not  only  for  the  loss  to 
his  functional  ability  but  also  to  his  appearance,  when  it 
seriously  interferes  with  his  ability  to  obtain  employ- 
ment in  the  grade  of  work  and  command  the  wages  to 
which  he  is  entitled.  The  part  of  his  ability  to  com- 
pete not  represented  in  the  person  himself,  but  in  the 
way  employers  consider  the  damages  we  render  in  the 
number  selected  for  the  index  of  the  radical  of  the  com- 
peting ability.  In  general,  if  a person  has  no  compet- 
ing ability  we  would  select  0 ; if  it  is  seriously  affected 
we  would  select  2 or  3 ; if  only  moderately  affected  5 or 
7 ; and  if  but  slightly  affected  10,  for  the  index  of  the 
radical  of  the  competing  ability.  By  leaving  this  to  the 
physicians  who  have  ascertained  the  damages  to  F,  and 
who  are  the  most  competent  to  judge  what  it  shall  be, 
disabilities  of  the  body,  and  an  indemnity  to  be  allowed 
therefor,  may  be  determined  in  a* manner  equitable  to  all 
concerned. 

The  higher  mathematics  involved  in  the  extraction  of 
the  roots  of  the  radicals  are  avoided  by  the  construction 
of  a chart  by  Prof.  Hart  of  the  University  of  Maine,  by 
which  geometric  curves  represent  the  different  roots ; the 
value  of  the  abscissa  being  given  at  the  top  and  bottom, 
and  that  of  the  ordinate  on  either  side.  By  taking  the 
remaining  decimal  value  of  the  unit  of  the  body,  as  ab- 
scissa, and  tracing  the  line  to  the  geometric  curve  repre- 
senting the  root  sought,  and  from  this  point  following 
the  ordinate  to  its  end  on  either  side,  the  value  of  the 
root  will  be  found.  Inserting  this  value  in  the  formula, 
the  process  of  finding  the  remaining  earning  ability  and 
thereby  the  damages  to  the  body  is  one  of  simple  compu-. 
tation,  involving  no  more  mathematics  than  an  example 
in  interest  or  partial  payments. 

Although  it  is  true  that  scientific  standards  of  meas- 
urement of  all  the  parts  of  the  units  of  the  body  have  not 
been  determined  and  agreed  on,  nevertheless  it  is  a 
self-evident  fact  that  anything  that  is  used  must  have  a 
value  placed  upon  it,  and  when  this  value  has  been  meas- 
ured, tested,  compared,  and  estimated  in  a scientific  man- 


13 


uer,  in  a large  number  of  normal  healthy  persons,  and 
an  average  value  ascertained,  this  average  value  becomes 
a scientific  standard  of  measurement  for  that  particular 
part  of  the  unit  of  the  body.  It  is  in  this  way  that  all 
the  scientific  standards  of  measurement,  now  employed, 
have  been  determined  and  agreed  on,  and  it  is  in  this 
way  that  all  the  remaining  ones  must  be  established. 
Until  this  work  is  consummated  we  shall  have  to  employ 
such  standards  as  have  been  agreed  on,  and  by  the  same 
methods  by  which  these  have  been  obtained  determine 
values  for  all  the  remaining  systems  and  organs  of  the 
units  of  the  body  which  will  eventually  be  accepted  as 
scientific  standards  of  measurement. 

In  ascertaining  damages  to  the  body,  a physician 
must  first  determine  what  the  impairment  of  the  func- 
tion of  the  unit  is,  and  then,  by  comparing  this  with  the 
case  record  and  the  scientific  standard  of  measurement 
for  it,  give  the  remaining  value  in  the  form  of  a fraction 
of  the  whole  unit  in  the  formula.  The  principles  and 
process  then  are  the  same  as  those  employed  in  deter- 
mining the  efficiency  of  any  physical  force.  It  will  be 
seen  that  it  is  the  daniaged  functions  that  the  physician 
first  seeks,  and  not  necessarily  the  pathology  of  the  dam- 
aged unit.  To  illustrate  this,  a physician  might  in  ex- 
amining the  eyes  find  the  sight  seriously  impaired,  the 
fields  markedly  contracted,  and  the  muscular  move- 
ments  badly  deranged.  He  could  determine  the  exact 
functional  disability  of  each  of  these  units  of  the  eyes  by 
the  scientific  standards  of  measurement  for  them,  and 
give  the  remaining  value  of  each  unit  in  the  form  of  a 
fraction  for  the  Magnus  formula,  and  thereby  ascertain 
the  remaining  earning  ability  of  the  eyes  without  know- 
ing the  pathology  of  the  disabilities.  The  exact  nature 
of  the  disabilities  could  not  be  determined  without  insti- 
tuting an  examination  which  would  reveal  their  path- 
ology, and  therefore  the  physician  could  not  state  whether 
the  disabilities  were  temporary  or  permanent  without 
such  an  examination.  The  pathology  of  a disability  is 
necessary  only  to  determine  its  character,  whether  trans- 
itory or  permanent,  serious  or  not,  as  the  case  may  be. 
and  should  not  be  made  the  basis  to  determine  the  re- 
maining earning  ability  of  the  body.  The  earning  abil- 
ity is  a composite  quantity  made  up  of  the  physiologic 
functions  of  the  systems  and  organs  of  the  units  of  the 


13 


body,  each  of  which  is  interdependent  on  the  other  in 
making  man  the  most  wonderful  product  of  nature. 

In  youth  and  the  beginning  of  manhood,  we  can  only 
rate  a person  according  to  his  functional  and  his  tech- 
nical ability,  but  when  that  person  has  a fixed  occupation 
we  can,  thereby,  determine,  by  our  formula,  his  earning 
ability  and  his  economic  power  in  the  world  as  accurately 
as  we  can  that  of  any  physical  force.  We  can  determine 
his  mental  ability  only  so  far  as  it  is  manifested  in  his 
vocation  and  the  importance  placed  on  it  as  evidenced  in 
the  remuneration  he  receives  for  it.  We  can  not  figure 
on  possible  prospects  of  advancement,  nor  change  of 
occupation.  We  can  only  figure  on  the  actual  conditions 
of  life  as  they  exist,  and  when  accidents  occur,  causing 
damage,  on  the  supposition  that  these  conditions  would 
continue  for  a length  of  time  thereafter  according  to 
the  basis  on  which  the  American  experience  table  of 
mortality  has  been  constructed  and  on  which  has  been 
established  life  insurance — the  first  business  of  the 
world. 

The  value  of  the  functions  of  the  body  cannot  be  deter- 
mined, for  health,  like  character,  is  priceless.  Even  the 
possession  of  health  much  below  any  economic  value  is 
priceless,  and  is  clung  to  under  all  conditions  of  priva- 
tion and  suffering.  This  does  not  affect  the  purpose  of 
our  formula,  which  represents  mathematically  the  nor- 
mal earning  ability  of  the  body.  This  has  solely  to  do 
with  the  individuaTs  ability  to  perform  certain  services 
and  to  receive  a specific  compensation  therefor  for  the 
remainder  of  a prospective  working  life.  Ho  life  insur- 
ance company  would  consider  a risk  on  a man^s  life  for 
an  amount  his  business  or  wealth  did  not  warrant.  A 
man  who  has  no  income  whatever  and  could  offer  no 
collateral  would  be  refused  a loan  of  money  from  any 
person,  or  bank,  and  he  could  not  obtain  money  except 
by  reasons  which  are  foreign  to  the  rules  of  business. 
A person  with  good  habits  and  a steady  occupation  with 
a specified  income  would  be  able  to  hire  money  on  that 
alone,  in  proportion  to  his  income,  other  things  being 
equal.  The  time  is  coming  when  the  earning  ability  of 
man  will  be  rated  and  will  be  just  as  valuable  in  the  labor 
market  as  in  the  rating  of  his  financial  ability  to-day  in 
the  business  marts  of  the  world. 

We  will  now  proceed  to  illustrate  the  use  of  the  for- 
mula in  the  case  of  a young  man  whose  eyes  were  severely 


14 


damaged  and  the  right  hand  badly  burned  by  a current 
of  electricity  sufficient  to  kill  two  men  instantly. 

W.  O’B.  * aged  20,  mill  employ^,  June  22,  1900,  while  stand- 
ing on  an  iron  platform  and  handling  a portable  electric  light, 
received  a current  of  electricity  sufficient  to  throw  him  down 
instantly.  Two  of  his  fellow-workmen  who  saw  him  fall 
quickly  went  to  his  aid  and,  in  attempting  to  pull  him  away 
from  the  platform  and  the  wire  of  the  lamp,  which  was  burn- 
ing his  hand,  both  were  killed  instantly.  The  electric  current 
was  shut  off  as  soon  as  possible  and  Mr.  O’B.  was  extricated 
from  his  perilous  position.  Dr.  G.  F.  Webber  of  Fairfield, 
Maine,  was  called  to  attend  him  and  stated  that  the  fiexor 
tendons  of  the  thumb  and  forefinger  were  burned  off  and  the 
flesh  of  the  other  fingers  was  burned  severely.  The  hair  and 
scalp  to  the  size  of  a silver  dollar  were  burned  off  where  the 
back  of  the  head  rested  on  the  iron  platform.  He  was  uncon- 
scious for  seven  or  eight  hours  after  the  accident. 

There  was  evidence  that  the  wires,  of  the  electric  light  com- 
pany, outside  the  mill  became  crossed  in  the  mill  yard,  the 
primary  wire  carrying  a current  of  2,200  volts. 

When  the  wound  healed  the  thumb  became  adherent  to  the 
forefinger  so  he  was  unable  to  grasp  anything  between  the 
forefinger  and  the  thumb.  His  sight  was  seriously  affected, 
and  he  came  under  the  care  of  Dr.  J.  F.  Hill  of  Waterville, 
Maine.  He  also  consulted  Hon.  Charles  F.  Johnson  of  Water- 
ville to  ascertain  how  he  might  recover  damages  for  his 
injuries. 

On  Sept.  13,  1901,  I made  an  examination  of  Mr.  O’B.  with 
the  following  results:  Vision  right  eye  0.1,  no  improvement 
with  lenses.  Vision  left  eye  0.4,  no  improvement  with  lenses. 
Corneal  astigmatism  right  eye,  1 D.  at  90°;  left  eye,  0.8  D.  at 
90°;  abduction,  4°;  adduction,  14°;  esophoria,  5%°;  sursum- 
duction  right  eye,  3°;  left  eye,  3°.  Deciphers  type  No.  10 
(3l^  mm.  in  height).  The  right  field  of  vision  was  contracted 
30°  on  the  temporal  side  and  20°  above,  below  and  on  the  nasal 
side.  The  left  field  of  vision  was  contracted  about  10°  in  all 
directions.  No  limitations  of  the  muscular  movements  were 
recorded. 

Examination  of  the  interior  of  the  eyes  showed  the  media 
fairly  clear,  so  that  the  retina  and  optic  nerve  of  each  eye 
could  be  seen  readily.  It  was  evident  from  the  ophthalmo- 
scopic appearance  that  both  the  nerve  and  retina  of  each  eye, 
especially  of  the  right  eye,  had  suffered  from  inflammation, 
but,  of  course,  there  was  nothing  in  the  slight  changes  to  indi- 
cate the  cause  of  it  or  when  it  may  have  occurred. 

He  was  examined  again  on  Dec.  27,  1901,  and  his  condition 
was  found  to  be  about  the  same  as  here  recorded. 

The  suit  was  brought  for  $5,000,  and  the  trial  took  place  at 
Skowhegan,  Maine,  in  December,  1901,  Hon.  A.  S.  Littlefield 
of  Rockland  being  the  attorney  for  the  pulp  mill  company. 


15 


Mr.  Littlefield  consulted  me  about  testifying  for  the  defense. 
After  I stated  to  him  I was  engaged,  and  the  substance  of  my 
testimony,  he  did  not  engage  any  one  to  testify  as  to  the 
condition  of  the  eyes,  but  engaged  Dr.  W.  P.  Giddings  of 
Gardiner,  Maine,  to  testify  as  to  the  physical  condition  of 
Mr.  O’B.  After  a trial  of  several  days  the  jury  rendered  a 
verdict  for  Mt.  O’B.  of  $3,271.  This  verdict  was  set  aside 
afterward,  because  of  the  erroneous  ruling  of  the  judge  who 
held  the  pulp  mill  company  liable  for  negligence  of  the  elec- 
tric light  company  which  supplied  the  electricity. 

As  to  the  verdict  and  a new  trial  Mr.  Johnson  writes  me: 
“1  am,  of  course,  very  much  disappointed  that  the  verdict 
should  be  lost  on  what  really  had  nothing  to  do  with  the  de- 
cision of  the  case,  for  if  the  jury  had  been  correctly  instructed 
by  the  court,  I feel  very  certain  that  the  result  would  not 
have  been  changed,  but  as  attorneys,  we  have  to  learn  to  take 
the  bitter  with  the  sweet.  I intended  to  try  the  case  the 
second  time,  but  the  young  man’s  brother-in-law,  who  was 
able  to  furnish  him  some  financial  assistance^  died,  and  in  the 
meantime  the  young  man’s  hand  was  operated  on  in  the  hos- 
pital at  Augusta,  where  I got  him  a free  bed.  After  the 
operation  he  was  able  to  use  it  more  than  before  and  found 
employment  in  the  woolen  mills  at  Fairfield  at  the  same 
price  per  day  which  he  had  received  in  the  pulp  mill.  He 
never  will,  however,  have  a good  hand,  and  the  work  about 
which  he  is  employed  in  the  woolen  mill  does  not  call  for 
very  much  use  of  his  hand.  Certainly  through  the  remainder 
of  his  life  he  will  not  have  more  than  one-half  the  use  of 
that  hand.  The  last  time  I saw  him  in  1905  his  eyesight  was 
no  better.  When  he  undertook  to  read  or  look  at  an  object 
steadily,  or  for  any  length  of  time,  his  eyes  manifested  very 
marked  signs  of  weakness.  For  the  work  about  which  he  is 
now  employed  it  is  not  necessary  that  he  use  his  eyes  very 
much.  I think  otherwise  he  has  been  in  good  health  and  has 
continued  to  work  in  the  woolen  mill. 

‘‘The  insurance  company®  made  an  offer  of  $1,000,  which 
could  not  be  considered  in  any  light  adequate  compensation 
for  his  injuries.  However,  he  had  no  money  to  continue  liti- 
gation, and  he  was  able  to  work  some,  and  there  were  trou- 
blesome questions  of  law  about  the  liability  of  the  defendant 
company,  as  well  as  the  question  about  collecting  an  execu- 
tion from  the  pulp  mill,  I thought  it  best  to  accept  the  offer. 

“Since  I heard  your  lecture  on  physical  economics  at  Water- 
ville  I have  been  very  much  interested  in  the  subject.  The 
question  of  what  are  adequate  damages  for  personal  injuries  is 
always  a very  troublesome  one  for  the  courts,  and  the  juries 


3.  The  Insurance  company  was  one  that  Insured  the  pulp  mill 
company  against  liabilities  for  injuries  to  Its  employes  and  against 
the  cost  of  defending  suits  to  the  amount  of  $5,000  in  any  indi- 
vidual case. 


IG 


liave  no  certain  guide  to  go  by.  It  seems  to  me  that  you  have 
developed  a practical  method  for  rating  a person  and  for  de- 
termining damages  to  the  body  from  injuries  or  disease,  and  I 
sliall  hope  to  see  it  in  daily  use  in  the  near  future.” 

The  position  I took  at  the  trial  was  that,  inasmuch  as 
Mr.  O’B’s  eyes  had  never  been  examined  and  there  was 
no  record  of  the  condition  of  the  eyes  before  the  acci- 
dent, 1 could  only  state  the  condition  I found  them  in, 
and  the  probable  effect  this  would  have  on  his  future 
earning  ability.  In  answer  to  a question  as  to  the  prob- 
able effect  of  a current  of  electricity  of  high  voltage  on 
the  brain  and  organs  of  special  sense,  I replied  that  it 
could  not  be  definitely  determined  without  a carefully 
made  record  of  the  condition  of  a person  before  it  passed 
through  these  organs,  but  in  this  case,  inasmuch  as  two 
of  Mr.  O’B’s  comrades  were  killed,  instantly,  by  the  cur- 
rent which  must  have  passed  through  his  body  to  them, 
and  there  was  no  history  of  weak  eyes  to  offset  the  claim 
that  his  eyes  were  good  and  strong  before  the  accident, 
it  was  fair  and  equitable  in  my  opinion,  to  assume  that 
they  were  good  before  the  accident.  This  testimony  was 
acceptable  to  both  parties  to  the  suit. 

In  determining  the  damages  to  Mr.  O’B.  in  conse- 
quence of  the  partial  loss  of  the  functions  of  the  eyes,  it 
was  necessary  to  consider  the  loss  of  central  and  peri- 
pheral vision.  Central  vision  was  reduced  to  0.1  normal 
in  the  right  eye,  and  0.4  normal  in  the  left  eye.  As  nor- 
mal vision  according  to  the  standard  of  measurement  is 
not  essential  to  mill  employes,  that  is,  a large  number  of 
them  earn  and  receive  full  wages  when  vision  is  very 
much  below  this  scientific  standard  of  measurement  for 
normal  vision,  it  could  not  be  assumed  that  the  fractional 
part  of  the  loss  of  vision  lessens  the  earning  ability  of  the 
eyes  to  that  same  amount.  At  the  time  of  the  accident 
the  American  edition  of  Magnus’  work  had  not  appeared. 
I find,  however,  that  my  estimation  of  the  effects  of  the 
loss  of  vision  on  the  earning  ability  of  Mr.  O’B.  at  that 
time,  correspond  very  nearly  to  the  results  obtained  by 
the  standard  adopted  by  Magnus,  as  I assumed  then 
from  an  examination  of  a large  number  of  laborers  of 
different  vocations  that  one-half  of  the  scientific  stand- 
ard of  measurement  for  normal  vision  was  sufficient  for 
full  earning  ability,  provided  the  fields  of  vision  of  each 
eye  were  nearly  normal. 

The  loss  in  the  field  of  vision  in  this  case,  especially 
of  the  right  eye  of  30  degrees  on  the  temporal  side,  I re- 


17 


garded  seriously  as  it  is  the  same  in  amount  as  when  one 
eye  is  entirely  lost,  and  no  matter  in  what  direction  Mr. 
O^B.  looked  there  would  be  just  so  much  narrowing  of 
the  field  of  vision,  and  a corresponding  detriment  in  his 
ability  to  work  in  any  vocation  and  protect  himself  from 
dangers  without  that  are  constantly  menacing  persons 
with  such  a disability.  Considering  the  damages  on  this 
basis,  I determined  the  economic  loss  to  Mr.  O’B’s  eyes 
3/8  of  the  whole,  and,  therefore,  the  remaining  earn- 
ing ability  5/8.  This  corresponds  closely  to  the  results 
obtained  by  Mangus’  method  by  which  I figured  it  after 
the  American  edition  of  that  work  appeared. 

As  much  as  we  all  admire  the  work  of  Magnus,  and 
the  additions  made  to  it  by  the  translator  and  editor  of 
the  American  edition.  Dr.  Wilrdemann,  it  is  not  satis- 
factory to  determine  damages  to  the  eyes  by  one  method, 
and  damages  to  another  part  of  the  body,  which  were 
caused  by  the  same  injury,  by  an  entirely  different 
method,  therefore  I saw  the  necessity  of  adapting  the 
principle  employed  by  Magnus  in  his  formula  for  the 
normal  earning  ability  of  the  eyes  to  the  whole  body, 
and  developed  the  mathematical  formula  for  the  nor- 
mal earning  ability  of  the  body,  the  application  of  which 
to  solving  problems  in  cases  of  damages  to  the  body 
from  injury,  or  disease,  with  an  indemnity  to  be  allowed 
therefor,  is  the  object  for  which  this  paper  has  been  pre- 
pared. 

In  determining  the  remaining  earning  ability  of  Mr. 
O’B.  by  the  mathematical  formula  for  the  normal  earn- 
ing ability  of  the  body,  we  will  ascertain  the  remaining 
earning  ability  of  the  eyes,  first,  which  are  a part  of  one 
of  the  factors  in  unit  d. 

The  eyes,  as  Magnus  has  clearly  demonstrated,  have 
three  factors  which  are  absolutely  indispensable  to  their 
normal  earning  ability,  namely  the  central  acuity  of  vis- 
ion, the  field  of  vision,  and  the  muscular  movements. 
Although  these  factors  are  not  of  equal  value,  and  for 
that  reason  are  placed  under  a radical  in  the  Magnus 
formula,  nevertheless  if  either  one  of  the  two  lesser  ones 
in  value  be  totally  destroyed  the  earning  ability  of  the 
eyes  likewise  will  be  destroyed. 

Mr.  O’B^s  best  eye,  the  left,  which  determines  his  cen- 
tral acuity  of  vision,  was  0.4  normal  scientific  standard 
of  measurement.  Assuming  that  0.5  normal  scientific 
standard  of  measurement  is  sufficient  for  full  earning 


18 


ability,  which  is  the  standard  adopted  by  Magnus  for 
mill  employes,  he  had  lost  1/5  of  the  sight  actually 
needed  in  this  vocation,  and  therefore  had  4/5  left, 

.OJ  .lO  .ts  .*0  -SS  .50  ZS  .40  45’  SO  .S S .6  0 ZS  .To  .7S  AO  As'  '.SO  9S  1.00 


which  is  one  of  the  factors  of  the  coefficient  of  the  unit  d. 
The  vision  of  the  right  eye  was  0.1  of  the  normal  scien- 
tific standard  of  measurement,  and  the  loss  in  the  field  of 
vision  on  the  temporal  side  was  30°  of  the  normal  scien- 


i 


19 


tific  standard  of  measurement.  If  the  binocular  field  is 
divided  into  three  zones^  as  suggested  by  Schroeter,  and 
^ practiced  by  Magnus,  there  will  be  six  zones  of  30°  each, 

and  as  the  outer  zone  of  30°  was  gone,  there  was  5/6  left, 
which  in  consideration  of  the  serious  loss  of  vision  of 
this  eye,  should  be  placed  in  the  formula  at  its  full  value 
as  the  other  factor  of  the  coefficient  of  the  unit  d. 

The  defect  in  the  muscular  balance  of  the  eyes  (eso- 
phoria)  and  the  weakened  accommodation  were  not 
thought  sufficient  to  be  taken  into  account  in  the  calcula- 
tion. 

The  objective  damages  to  the  body  are  included  in  the 
unit  a.  The  damage  to  the  scalp  could  be  concealed  by 
the  hair  and  the  real  damage  from  this  particular  part 
was  to  unit  d,  which  has  already  been  determined. 

The  damage  to  the  right  hand  was  severe.  In  look- 
ing for  a standard  of  measurement  by  which  the  loss  of 
the  function  of  the  hand  could  be  compared  and  its  re- 
maining economic  value  be  determined,  I feel  sure  that 
all  who  saw  the  case  would  agree  that  the  disability  was 
equal  to,  or  greater,  than  ankylosis  of  the  wrist,  and  his 
competing  ability  would  be  less  than  a person  suffering 
from  ankylosis  of  the  wrist,  because  in  ankylosis  of  the 
wrist,  there  would  be  no  scar,  or  deformity,  only  the  loss 
of  motion,  whereas  Mr.  O^B.  had  loss  of  motion  and  a 
bad  looking  scar  of  the  hand.  If  this  disability  of  the 
hand  is  considered  equal  to  that  of  ankylosis  of  the 
wrist,  for  which  the  standard  of  the  Bureau  of  Pensions 
of  the  United  States  is  one-ninth  of  total  disability  and 
which  I have  shown  in  a paper  read  before  the  National 
Association  of  United  States  Pension  Examining  Sur- 
geons, at  Atlantic  City,  published  in  their  transactions 
for  1904,  is  equivalent  to  10  per  cent,  of  total  disability 
when  placed  in  the  mathematical  formula  for  the  normal 
earning  ability  of  the  body  and  the  competing  ability 
considered,  we  have  9/10  of  the  unit  a left,  which  is  its 
coefficient.  Discarding  all  undamaged  units  of  the  form- 

• ula,  we  have  as  an  expression  of  the  remaining  earning 
ability  of  the  body  of  Mr.  O’B.  when  placed  in  the  form- 
ula the  following: 

* E = 9/lOa  (4/5  x 5/6 )d  1/  9/lOa  (4/5  x 5/6d  = 
0.60  V 0.60. 

It  is  necessary  now  to  ascertain  Mr.  O’B’s  competing 
ability.  His  right  hand  was  a bad  looking  one,  and 


20 


moreover  its  functions  were  not  one-half  what  a normal 
hand  should  be,  which  would  prevent  him  from  obtain- 
ing emploj^ment  in  many  occupations.  Taking  the  ob^ 
jective  disability  of  the  right  hand,  and  the  subjective 
disability  of  his  eyes,  we  choose  5,  as  fair  and  equitable 
for  the  index  of  the  radical  of  his  competing  ability  on  a 
scale  of  2 being  used  when  the  competing  ability  is  the 
most  seriously  affected,  and  10  when  it  is  but  slightly 

affected.  We  then  have  E = 0.60  v/  o.60  = 0.60  x 0.905 
= 0.543 : E = 54.3  per  cent.  Therefore,  Mr. 
O’B.^s  remaining  earning  ability  is  54.3  per  cent,  of  hi? 
normal  earning  ability,  and,  hence,  his  economic  loss 
is  45.7  per  cent.  The  loss  in  wages  and  other  necessari 


expenses  connected  with  the  injury  are  as  follows : 

Two  and  one-fourth  years’  wages  at  $375 $843.75 

Less  $80  earned  canvassing  during  this  time....  80.00 


$763.75 

Physician’s  bill  for  services  208.00 

Druggist’s  bill  for  medicine 30.00 

Care  and  nursing,  estimated 42.00 

Cost  of  treatment  at  hospital  estimated 58.00 


Making  a total  of $1,101.75 


This  should  be  added  to  the  loss  of  the  earning  ability. 

We  will  now  proceed  to  determine  the  present  value  of 
Mr.  O^B.  at  the  time  of  the  accident  from  his  age  and  the 
wages  he  was  earning.  He  was  20  years  old  and  was 
earning  $1.25  per  day.  Assuming  he  would  work,  on  an 
average  of  300  days  in  the  year,  his  income  would  be 
$375.  This  would  allow  thirteen  days  each  common  and 
fourteen  days  on  leap  year  for  sickness  or  vacation.  It  is 
a close  approximation  to  what  ought  to  be  actually  rea- 
lized. 

The  cost  of  maintenance,  as  Dr.  Earr  says,  is  an  esti- 
mate, but  it  must  be  remembered  that  any  transaction 
of  man  must  have  a value  placed  on  it  and  when  this 
value  has  been  measured,  tested,  compared  and  esti- 
mated in  a scientific  manner,  in  a large  number  of  in- 
stances and  an  average  value  ascertained,  this  average 
value  becomes  a scientific  standard  of  measurement  for 
the  value  of  that  particular  transaction. 

We  need  a standard  of  measurement  for  the  economic 
value  of  man^  in  two  vocations,  the  average  laborer,  and 

4.  The  Bureau  of  Pensions  of  the  United  States  has  established 
$864  for  total  disability,  for  a soldier  or  sailor.  As  total  disa- 
bility requires  the  regular  aid  and  attendance  of  another  person  It 
may  be  inferred  that  this  amount  represents  the  gross  earnings  of 
two  persons,  and,  therefore,  the  earnings  of  one  would  be  one-half 
of  it  or  $432  a year,  $36  a month,  and  $1.44  a day. 


21 


the  average  professional  man.  The  first  should  be  ob^ 
tained  from  the  wages  of  a laborer  of  average  minimum 
capacity,  based  on  his  age,  his  physical  condition  and  his 
income.  The  present  value  of  the  net  income  must  be 
computed  at  a rate  of  interest  that  has  been  accepted  as 
a standard  for  such  computations,  which  we  have  as- 
sumed to  be  3.5  per  cent.,  as  nearly  all  insurance  values 
are  figured  at  this  rate. 

As  this  has  not  been  done  in  this  country  on  an  eco- 
nomic basis,  we  will  accept  Dr.  Farris  standard  for  a 
Norfolk  agricultural  laborer,  who  at  the  age  of  20,  earned 
£23  a year,  at  the  age  of  25,  £29  a year,  and  at  the  age 
of  30,  £31  a year,  and  thereafter  until  the  age  of  60,  £31 
a year.  Taking  an  average  of  £29  a year  and  reducing  it 
to  dollars  and  cents,  we  have  $140.94.  Dividing  $375 
by  $140.94  and  we  obtain  2.66  as  the  ratio  between  a 
Norfolk  agricultural  laborer  and  the  wages  Mr.  O’B.  was 
earning.  Multiplying  the  standard  for  the  present  eco- 
nomic value  of  a Norfolk  agricultural  laborer  as  deter- 
mined by  Dr.  Farr  on  a basis  of  5 per  cent,  per  annum 
by  2.66,  and  we  have  a standard  for  an  American  lab- 
orer, on  the  same  basis. 

In  another  table  Dr.  Farr  determines  the  present  eco- 
nomic value  of  a Norfolk  agricultural  laborer  on  a basis 
of  3 per  cent.  With  this  and  the  5 per  cent,  table,  we  ob- 
tain one  on  a 4 per  cent,  basis  and  with  the  4 per  cent, 
and  3 per  cent,  we  obtain  the  present  economic  value  on 
a 3.5  per  cent,  basis,  which  are  as  follows,  from  birth  to 
70  years  of  age. 


Age 

Total 

Died 

English 

American 

3%f?ibasis 

3%basis 

Birth 

5%basis 

5 basis 

513 

$26.10 

$69.43 

$119.54 

$146.64 

5 

372 

141 

271.87 

723.17 

1,245.16 

1,518.03 

10 

355 

17 

568.04 

1,510.99 

2,601.62 

4,169.66 

15 

346 

9 

930.93 

2,476.27 

4,263.66 

5,194.59 

20 

335 

11 

1,135.25 

3,019.77 

5,451.75 

6,295.74 

25 

321 

14 

1,197.26 

3,184.71 

5,488.03 

6,686.29 

30 

307 

14 

1,172.06 

3,117.03 

5,368.03 

6,540.09 

35 

291 

16 

1,109.15 

2,950.34 

5,079.91 

6,189.06 

40 

275 

16 

1,030.42 

2,740.92 

4,719.32 

5,749.73 

45 

257 

18 

936.81 

2,491.91 

4,290.59 

5,227.40 

50 

237 

20 

818.28 

1,910.02 

3,742.71 

4,566.00 

55 

215 

22 

669.80 

1,781.67 

3,067.68 

3,737.48 

60 

189 

26 

472.49 

1,256.82 

2,163.90 

2,636.49 

65 

156 

33 

223.56 

594.67 

1,023.90 

1,247.46 

70 

118 

38 

3.74 

9.95 

17.13 

20.87 

75 

79 

39 

—119.31 

317.37 

—546.44 

—565.75 

80 

44 

35 

—199.31 

530.16 

—872.74 

—1,112.15 

Multiplying  the  present  economic  value  for  the  age  of 
20,  as  here  obtained  by  the  percentage  of  the  remaining 
earning  ability  of  Mr.  O’B.,  and  we  have  the  amount  of 
his  remaining  earning  ability.  Subtracting  this  re- 


22 


maining  earning  ability  from  his  present  economic  value 
and  we  have  his  economic  loss,  then  adding  his  loss  in 
wages  and  his  expenses  after  the  injury,  and  we  have  his 
total  economic  loss  as  follows : 

$3,019.77  X .543  = $1,639.74  ; $3,019.77  — $1,639.74  = $1,380.03; 

$1,380.3  $1,101.75  = $2,481.78,  5 per  cent,  basis. 

$5,451.75  X .543  = $2,960.30  ; $5,451.75  — $2,960.30  = $2,491.45 ; 

$2,491.45  + $1,101.75  = $3,593.20,3%  per  cent,  basis. 
$6,295.74  X .543  = $3,418.58  ; $6,295.74  — $3,418.59  = $2,877.16 ; 

$2,877.16  + $1,101.75  = $3,978.91,  3 per  cent,  basis. 

Thus  we  see  that  the  total  economic  loss  to  Mr.  O’B. 
varies  according  to  the  rate  per  cent,  used  in  computing 
his  present  value  at  the  time  of  the  accident.  To  which- 
ever amount  that  may  be  accepted  as  equitable,  should 
be  added  such  a sum  for  the  suffering  in  mind  and  body, 
as  may  be  warranted  on  philanthropic  grounds. 

When  these  methods  are  accepted  as  a means  of  ad- 
justing damages  to  the  body  from  injury  or  disease,  it 
will  be  necessary  only  to  determine  who  was  responsible 
for  the  accident  that  caused  them,  then  the  settlement 
may  be  made  in  a manner  equitable  to  all  concerned. 

The  amount  for  which  suit  was  brought,  ($5,000)  in 
view  of  the  serious  damage  to  Mr.  O’B.,  was  not  an  un- 
reasonable sum  for  such  damages,  as  shown  by  his  eco- 
nomic value  at  the  time  of  the  accident  and  from  his 
remaining  earning  ability,  as  determined  by  scientific 
and  economic  standards  of  measurement,  and  the  math- 
ematical formula  for  the  normal  earning  ability  of  the 
body.  When  the  present  value  of  Mr.  O’B.  is  determined 
at  the  rate  of  5 per  cent,  discount,  the  amount  that 
should  be  paid  him  is  $789.22  less  than  the  amount  of 
the  verdict  rendered  by  the  jury;  when  determined  at  3.5 
per  cent,  it  is  $322.20  more  than  that  rendered  by  the 
jury;  while  at  3 per  cent,  it  is  $707.91  more  than  that 
rendered  by  the  jury. 

We  believe  that  if  the  jury,  in  this  case,  could  have 
had  these  methods,  as  here  worked  out,  demonstrated  to 
•them,  their  duty  would  have  been  easier  to  perform  and 
the  results  would  have  been  more  satisfactory  to  them- 
selves. However,  we  have  no  criticism  to  make  on  the 
verdict  rendered,  considering  the  standpoint  from  which 
it  was  ascertained. 

In  determining  a standard  of  measurement  for  the 
present  value  of  a man  in  the  United  States,  we  believe 
that  the  wages  earned  by  Mr.  O’B.  at  the  time  of  the  ac- 
cident, $1.25  per  day,  are  an  average  minimum  for  this 
•^country  and  that  the  rate  of  interest  of  3.5  per  cent,  per 


23 


annum,  may  be  accepted  as  a standard  for  computation. 

Dr.  Farr  determines  the  present  value  of  persons  in 
professions  on  moderate  incomes,  earning  £288  a year, 
or  $1,399.78,  practically  $1,400,  or  $4.50  per  day,  inter- 
est 3 per  cent.,  as  follows : 


1.  Age  25,  economic  value $25,898.94 

2.  Age  30,  economic  value 27,702.00 

3.  Age  35,  economic  value 28,921.86 

4.  Age  40,  economic  value 29,344.68 

5.  Age  45,  economic  value 28,829.52 

6.  Age  50,  economic  value 27,138.24 

7.  Age  55,  economic  value 23,974.38 

8.  Age  60,  economic  value 19,337.94 

9.  Age  65,  economic  value 13.209.48 

10.  Age  70,  economic  value 2,988.00 


It  will  be  seen  by  reviewing  the  methods  by  which  the 
damages  to  Mr.  O’B.  have  been  determined,  that  every 
step  in  the  process  has  been  taken  with  a well-defined  ob- 
ject in  view,  and  that  it  has  been  accomplished  by  the 
use  of  a mathematical  formula  for  the  normal  earning 
ability  of  the  body,  based  on  the  principles  employed  in 
the  natural  sciences  in  ascertaining  the  value  of  any 
physical  power,  and  therefore  is  scientifically  correct. 
The  two  values  to  be  determined  in  the  case  were  first, 
his  remaining  earning  ability,  in  the  form  of  a fraction - 
of  the  normal  earning  ability,  and  second,  his  economic 
value  at  the  time  of  the  accident.  We  determined  the 
first  by  comparing  the  conditions  found  in  the  eyes  with 
such  economic  standards  of  measurement  of  the  eyes  as 
have  been  found  by  the  examination  of  a large  number 
of  cases  by  different  observers  to  be  sufficient  for  a mill 
employe  to  perform  the  work  required  of  him  success- 
fully, and  give  the  remainder  in  the  form  of  a fraction 
for  each  of  the  factors  of  the  eyes  thus  involved.  These 
remaining  values  of  the  factors  of  the  eyes  were  multi- 
plied together  for  the  coefficient  of  the  unit  d to  which 
they  belong. 

We  obtained  the  remaining  value  of  the  hand  by  com- 
paring the  disability  with  the  standard  of  measurement 
established  by  the  Bureau  of  Pensions  of  the  Dnited 
States  for  all  minor  disabilities,  namely,  ankylosis  of 
the  wrist,  by  which  millions  are  paid  to  soldiers  and 
sailors  annually.  We  then  had  the  remaining  value  of 
the  damaged  units  a and  d,  as  their  coefficients,  and  dis- 
carding h and  c because  not  considered  injured,  and 
therefore  equal  to  one  e^ch,  we  have  the  formula  com- 
plete for  working,  except  the  index  of  the  radical  of  the 
competing  ability.  • The  number  for  the  index  of  the 
radical  of  the  competing  ability  is  determined  by  a moth- 


24 


od  based  on  principles  as  well  defined  as  those  employed 
in  rating  a person  at  school  or  college.  With  this  chosen, 
we  proceed  to  work  the  formula  according  to  the  prin- 
ciples upon  which  it  is  constructed,  and  obtained  the  re- 
maining earning  ability  of  Mr.  O^’B.  in  the  form  of  a 
fraction  of  the  normal  earning  ability  as  54.3  per  cent. 

Thus  every  step  of  the  process  to  determine  the  eco- 
nomic value  of  the  damage  to  Mr.  O’B.  in  consequence 
of  the  injury  he  received  June  22,  1900,  has  been  taken 
with  a well-defined  method  of  procedure,  as  that  of 
weighing  or  measuring  of  any  commodity  and  then  mul- 
tiplying the  quantity  by  the  price  per  unit  of  the  stand- 
ard of  measurement  for  that  commodity,  in  order  to  ob- 
tain its  value.  The  final  result  then  can  not  be  ques- 
tioned on  the  ground  of  the  want  of  care  in  obtaining  it, 
it  can  only  be  questioned  on  the  ground  as  to  whether 
the  principles  on  which  the  methods  are  based  are  correct 
and  give  results  that*  are  right  and  equitable  to  all  con- 
cerned. 

On  both  of  these  points  we  have  the  highest  authority, 
for  my  formula  for  the  normal  earning  ability  of  the 
body  is  based  upon  the  principles  employed  in  the 
sciences  in  determining  the  value  or  efficiency  of  any 
natural  power.  It  was  employed  by  Magnus  in  his 
mathematical  formula  for  the  normal  earning  ability  of 
the  eyes.  My  work  has  been  to  adapt  these  principles  to 
the  entire  body  by  selecting  and  arranging  the  different 
systems  and  organs  according  to  their  development  and 
associated  functions,  that  all  the  essential  parts  of  the 
body  may  be  grouped  under  four  units,  which  may  be 
used  as  factors  of  the  functional  ability  in  a practical 
formula  as  readily  as  though  the  principles  were  applied 
to  but  one  organ  at  a time. 

For  the  success  and  approval  of  this  work, . I have 
quoted  from  one  of  the  many  letters  which  I have  re- 
ceived, because  Dr.  Seaver,  as  he  writes,  has  spent  a large 
part  of  his  life  in  studying  the  body,  to  develop,  measure, 
and  utilize  it  to  the  best  advantage.  He  has  written  one 
of  the  best  works  on  anthropometry  and  physical  exam- 
inations in  the  English  language,  and  therefore  his  opin- 
ion is  an  authority  on  this  subject. 

As  to  the  method  of  determining  the  present  economic- 
value  of  a person,  I have  quoted  from  the  highest  Eng- 
ii>ii  <iuiiioi  u\,  and  rheretore,  of  the  world,  because  the 


25 


science  of  vital  statistics  owes  its  existence  largely  to 
English  writers,  the  greatest  of  whom  was  Dr.  Farr. 

After  admitting  the  principles  of  the  methods  and 
every  step  of  the  process  taken  in  the  solution  of  this 
problem  are  correct,  it  might  be  argued  that  the  final  re- 
sult is  not  equitable  because  Mr.  O^B.  has  obtained  work 
in  a woolen  mill  for  the  same  wages  he  received  at  the 
time  of  the  accident. 

This  argument  would  be  too  fallacious  to  need  refuta- 
tion when  the  history  of  the  case  and  the  conditions 
under  which  Mr.  O’B.  now  works  are  taken  into  con- 
sideration. He  must  at  the  best,  always  take  an  inferior 
position.  The  current  of  electricity  which  passed  through 
his  body  was  sufficient  to  kill  two  men,  and  the  bad  ef- 
fects may  gradually  develop,  thus  farther  disabling  him. 
This  is  no  small  consideration  in  the  problem,  but  it  is 
not  taken  into  account  in  the  result  obtained.  We  have 
endeavored  to  be  conservative  in  every  step  of  the  pro- 
cess, and  believe  the  result  is  obtained  in  a manner  equit- 
able to  all  concerned. 

One  important  datum  is  lacking  in  the  absence  of  a 
record  of  an  examination  of  the  eyes  before  the  accident, 
and,  therefore,  we  are  unable  to  assert  positively  that  the 
conditions  of  his  eyes,  as  found  after  the  accident,  was 
due  to  the  injury,  but  we  are  confident  that  the  position 
taken  is  fully  justified  by  the  history  of  the  case,  and  the 
nature  of  the  injury. 

We  have  gone  into  the  details  of  this  case  at  consider- 
able length,  because  it  illustrates  how  well  the  formula 
is  adapted  to  working  out  the  remaining  earning  ability 
of  a person  when  one  or  more  of  the  units  of  the  body 
has  been  damaged  by  injury  or  disease,  and,  therefore, 
it  is  a type  of  all  such  cases. 

If  Mr.  O^B.  had  had  a record  of  an  examination  of 
his  eyes  showing  that  they  were  normal  prior  to  the  acci- 
dent, all  doubt  on  this  point  would  have  been  removed. 
This  again  shows  the  necessity  of  every  person  having  a 
case  record  of  his  physical  condition,  for  no  one  knows 
when  he  may  meet  with  an  accident  and  need  it  to  deter- 
mine just  what  the  amount  of  the  damage  is  from  a given 
injury.  If  the  history  and  examination  revealed  a sus- 
picion that  a part  of  a disability  existed  prior  to  the  acci- 
dent for  which  damages  are  claimed,  and  this  should  be, 
by  further  evidence  in  the  case,  established  beyond  a 
reasonable  doubt,  then  the  fact  must  be  taken  into  con- 


26 


sideration  in  determining  the  amount  of  the  damages 
due  to  the  accident.  To  avoid  disputes  and  litigations 
every  person  should  have  a carefully  made  record  from 
repeated  examinations  of  his  body. 

This  would  be  of  great  value  to  a person,  not  only  in 
case  of  injury,  but  also  in  the  treatment  of  any  disease. 

The  progress  of  medicine  is  towards  preventing,  rather 
than  curing  diseases,  and  in  order  to  make  this  practice 
more  complete,  the  time  is  coming  when  physicians  will 
be  largely  occupied  in  making  these  examinations  and 
case  records,  and  thereby  preventing  rather  than  curing 
diseases.  There  is  nothing  of  more  importance  to  be  in- 
stituted in  the  science  and  practice  of  medicine  for  its 
welfare  and  advancement  than  the  carefully  made  rec- 
ords of  the  physical  and  laboratory  examinations  of 
every  person.  To  make  them  more  effective  they  should 
be  instituted  when  the  child  enters  school,  and  be  re- 
peated at  stated  times  during  the  whole  period  of  school 
life.  This  would  necessitate  establishing  a new  officer, 
the  school  physician,  not  an  inspector  of  the  schools,  but 
one  who  would  take  a child,  analyze  him,  detect  all  ab- 
normalties  and  in  conjunction  with  the  parents  and  other 
physicians  correct  them  during  school  life,  and  thus  have 
the  body  improve'd  with  the  mind,  that  each  may  help  the 
other  to  the  fullest  development.  From  these  records 
data  could  be  obtained  which,  when  applied  to  the  math- 
ematical formula  for  the  normal  earning  ability  of  the 
body,  and  worked  out  according  to  the  principles  on 
which  it  is  constructed,  would  give  the  rating  of  a child, 
taking  into  consideration  his  functional  ability  on  which 
his  technical  ability  so  largely  depends,  but  which  has 
been  heretofore  almost  entirely  neglected  in  rating  him. 
With  this  work  carried  out  during  school  life,  it  would 
soon  demonstrate  its  own  importance,  by  making  these 
records  of  the  highest  value  in  the  training  of  the  mind 
and  the  body,  the  advancement  of  the  race,  for  the  pro- 
motion of  health  and  the  prevention  of  disease,  and  in 
furnishing  data  to  determine  damages  to  the  body  from 
injury  or  disease  by  the  mathematical  formula  for  the 
normal  earning  ability  of  the  body,  in  a manner  equit- 
able to  all  concerned. 


DISCUSSION. 

Dr.  H.  V.  WuRDEMANN,  Milwaukee,  said  that  one  could  talk 
for  hours  and  still  not  convince  some  people  that  mathematics 
can  be  applied  to  this  question.  Some  definite  standard  is 


27 


needed  in  court.  To  say  that  a person  has  lost  one-half  his 
visual  activity  means  nothing;  it  is  a matter  of  dollars  and 
cents  and  one  should  be  able  to  state  that  a man  has  lost  a 
certain  per  cent,  of  his  earning  ability,  a certain  amount  in 
dollars  and  cents.  Such  studies  as  those  of  Farr  and  Magnus 
have  demonstrated  that  mathematics  may  be  applied  to  deter- 
mining the  function  ability  of  man  to  compete  with  his  fel- 
low. It  has  been  demonstrated,  mainly  through  the  German 
observers,  that  there  are  definite  visual  factors  which  may  be 
damaged,  and  which  damage  may  have  a definite  infiuence  on 
the  earning  ability.  In  court  two  questions  arise : a question  of 
fact  and  a question  of  opinion.  If  an  opinion  be  generally  ac- 
cepted by  any  profession  it  has  almost  as  much  weight  in 
court  as  a fact.  We  will  not  for  many  years  reach  a position 
in  which  these  formulje  will  be  received  as  the  general  opinion 
of  the  profession,  yet  even  now  they  have  some  weight.  There 
is  a remarkable  similarity  of  results  obtained  by  the  method 
of  Magnus  and  Wiirdemann  to  damages  given  in  several  hun- 
dred suits  that  he  has  studied;  a remarkable  similarity  in  the 
amount  given  empirically  to  that  found  by  mathematical 
standards.  Dr.  Holt’s  paper  goes  very  far  into  the  future.  It 
will  be  a long  time  before  such  an  opinion  will  be  favorably 
received  by  the  general  profession  and  accepted  by  courts  and 
juries.  He  thought  that  the  citation  of  the  case  of  Mr.  O’B. 
was  rather  unfortunate,  inasmuch  as  he  was  able  to  earn 
practically  the  same  amount  after  the  accident  as  before.  What 
we  need  now  is  statistics  and  each  one  can  contribute  to  the 
literature  one  or  more  cases  showing  the  amount  of  earning 
capacity  after  a certain  accident.  It  is  only  by  such  evidence 
that  we  will  be  able  ultimately  to  determine  exactly  the  per- 
centage of  loss  of  earning  ability  following  a given  accident. 
At  the  Ophthalmological  Congress  at  Lucerne  three  men  were 
called  on,  one  to  represent  France,  one  Germany  and  one  the 
American  and  English,  to  get  what  evidence  they  could  and 
endeavor  to  establish  some  standard  whereby  to  determine  the 
resulting  loss  from  injury  to  an  eye.  In  Great  Britain  the 
loss  is  placed  at  50  per  cent,  for  one  eye.  A man  earning  28 
shillings  4 pence  a week  got  his  50  per  cent,  relief  and  in  addi- 
tion 38.3  per  cent,  from  a fraternal  society,  so  that  it  paid  him 
to  be  sick.  The  Germans  allow  33  1/3  per  cent,  insurance  for 
loss  of  an  eye.  He  did  not  think  he  could  go  as  far  as  Dr. 
Holt  until  we  have  accumulated  a great  number  of  statistics 
on  the  subject.  It  is  only  by  an  accumulation  of  such  statis- 
tics, where  individuals  suffering  certain  accidents  have  been 
damaged  in  a definite  pecuniary  way,  that  we  can  arrive  at  an 
opinion  in  the  matter  that  will  be  received  by  the  courts  as  a 
statement  of  fact. 

Dr.  L.  Webster  Fox,  Philadelphia,  said  that  these  questions 
are  of  very  great  importance  to  ophthalmic  surgeons  located  in 
manufacturing  centers.  Some  system  is  needed  by  which  an 


28 


opinion  can  be  formed  as  to  the  value  of  an  injured  eye,  arm 
or  leg.  Unfortunately  for  statistics  in  America,  accident  cases 
are  taken  up  by  unscrupulous  attorneys  and  fought  on  a con- 
tingent-fee basis,  and  many  of  these  cases  are  settled  out  of  the 
courts.  In  Philadelphia  are  very  large  manufacturing  inter- 
ests, and  it  is  important  to  the  ophthalmic  surgeon  that  some 
set  of  tables  be  prepared  in  a manner  in  which  he  can  use  them 
for  reference  of  value.  At  the  Baldwin  locomotive  works  17- 
000  men  are  employed;  the  Medico-Chirurgical  Hospital  re- 
ceives a large  number  of  the  accident  eases;  but  by  a system 
of  their  own  they  prevent  the  cases  from  getting  into  the 
courts.  There  are  many  other  cases  in  which  it  is  a difficult 
problem  to  settle  the  damages.  Recently  he  saw  a case  in 
which  both  eyes  were  destroyed  and  the  plaintiff  received  the 
sum  of  $10,000  from  a sympathetic  jury;  the  accident  in  this 
case  was  partly  due  to  the  man’s  own  negligence.  Now  when  an 
opinion  is  asked,  the  physician  can  at  least  give  the  courts  an 
idea  of  the  value  of  the  earning  ability  of  such  an  individual 
by  referring  to  Holt’s  system  of  valuation,  thereby  giving  a 
pro  rata  share  of  his  loss.  Each  occupation,  of  course,  is  a 
law  unto  itself  and  differs  in  degree;  some  men  receive  $20 
or  $30  a week,  others  $10  or  $15.  He  believes  that  the  move- 
ment is  a practical  one  and  should  be  taken  up  by  the  -asso- 
ciation, for  it  lessens  the  power  of  a jury  to  determine  the 
value  of  a lost  eye  in  such  cases. 

Dr.  Edward  Jackson,  Denver,  said  that  a mathematical 
formula  is  simply  a method  of  stating  some  fact.  An  enormous 
number  of  facts  that  Ave  do  not  think  of  as  having  anything 
to  do  with  mathematics  can  be  stated  in  rigid  mathematical 
formulae.  To  study  these  facts  in  any  way  is  to  render  them 
clearer  in  our  own  minds,  and  on  this  account  he  thinks  we 
ought  not  to  leave  these  formulae  to  Dr.  Holt  or  Dr.  Wiirde- 
mann,  or  any  feAV  men  especially  interested  in  the  subject. 
The  formulae  are  not  complete,  and  that  is  a reason  for  bring- 
ing them  before  this  section.  In  order  to  complete  them  we 
must  have  observations  made  by  a large  number  of  the  profes- 
sion. These  analyses  of  Dr.  Holt  have  largely  to  do  Avith 
functional  ability.  If  Ave  can  get  definite  reports  from  actual 
cases,  in  which  the  earning  ability  before  and  after  the  acci- 
dent has  been  ascertained,  our  estimate  of  the  real  impairment 
of  economic  ability  will  be  better.  Functional  ability  may 
contribute  to  various  things,  as  the  comfort  and  pleasure  of 
the  indiAudual,  etc.,  but  in  this  connection  it  is  Avith  reference 
to  productiA’^e  work,  and  the  actual  facts  can  only  be  settled 
by  the  combined  experience  of  the  profession.  Functional 
ability  is  the  foundation  of  the  AA’hole  subject  and  must  be 
settled  by  our  united  statistics.  Some  day  it  aauII  be  settled 
in  that  AA’ay,  and  if  the  members  of  this  section  Avill  consider 
the  cases  that  come  to  their  notice  in  the  next  year,  or  the 
next  fi\’e  years,  Avith  reference  to  this  point,  there  aauII  result 


29 


a basis  of  observed  facts  wbich  will  make  these  formulae  of  the 
greatest  value. 

Dr.  E.  E.  Holt,  Portland,  Me.,  agreed  with  Dr.  Jackson  that 
the  functional  .ability  is  the  most  important  element  in  the 
problem,  but  he  said  further  that,  as  he  had  shown  in  the  dis- 
cussion of  the  formula  for  the  normal  earning  ability  of  the 
body,  the  functional  ability  of  the, body,  however  perfect,  would 
be  of  no  economic  value  without  the  technical  and  competing 
ability  of  the  person  to  go  with  it  and  make  it  useful.  It 
should  be  demonstrated  that  the  economic  value  of  man  can  be 
ascertained  as  readily  as  any  of  the  values  on  which  insurance, 
the  first  business  of  the  world,  is  based.  With  these  methods 
the  economic  value  of  a person  at  any  age  can  be  demonstrated 
to  all  interested  parties,  and  then  a standard  has  been  estab- 
lished for  a base  on  which  to  compute  that  person’s  economic 
loss  when  damaged  from  injury  or  disease.  In  a number  of 
cases  he  had  been  consulted  privately  and  has  figured  the 
problem  out  according  to  the  methods  here  presented  with  so 
much  satisfaction  that  the  cases  have  been  settled  out  of  court. 
With  standard  methods  of  procedure  to  ascertain  the  economic 
value  of  a person  at  any  age,  according  to  his  functional  and 
his  net  earning  ability,  that  person’s  present  economic  value 
can  be  readily  determined ; and,  with  the  mathematical  formula 
for  the  normal  earning  ability  of  the  body,  with  the  requisite 
data,  that  person’s  economic  loss  can  be  determined  when  he 
has  been  damaged,  in  a manner  equitable  to  all  concerned. 
Thus,  in  a given  case,  what  is  right  and  equitable  can  be  ascer- 
tained; this  is  of  very  much  more  importance  than  collecting 
statistics  of  what  is  being  done  under  present  empirical 
methods. 


